{"id":13031,"date":"2020-11-24T09:05:08","date_gmt":"2020-11-24T09:05:08","guid":{"rendered":"http:\/\/onlineclassesguru.com\/index.php\/2020\/11\/24\/examination-of-breast-genitalpostate-and-rectal\/"},"modified":"2020-11-24T09:05:08","modified_gmt":"2020-11-24T09:05:08","slug":"examination-of-breast-genitalpostate-and-rectal","status":"publish","type":"post","link":"https:\/\/onlineclassesguru.com\/index.php\/2020\/11\/24\/examination-of-breast-genitalpostate-and-rectal\/","title":{"rendered":"Examination of breast, genital,postate and rectal"},"content":{"rendered":"<style type=\"text\/css\"><\/style><p><strong>Episodic note Case Study<\/strong>\u00a0: \u00a0Special Examinations\u2014Breast, Genital, Prostate, and Rectal<\/p>\n<p>GENITALIA ASSESSMENT<\/p>\n<p><strong>Subjective<\/strong>: \u2022 CC: \u201cI have bumps on my bottom that I want to have checked out.\u201d<\/p>\n<p>\u2022\u00a0<strong>HPI<\/strong>\u00a0AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She state: s the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.<\/p>\n<p>\u2022\u00a0<strong>PMH:<\/strong>\u00a0Asthma \u2022 Medications: Symbicort 160\/4.5mcg \u2022 Allergies: NKDA \u2022\u00a0<strong>FH:<\/strong>\u00a0No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD \u2022 Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)<\/p>\n<p><strong>Objective:<\/strong>\u00a0\u2022 VS: Temp 98.6; BP 120\/86; RR 16; P 92; HT 5\u201910\u201d; WT 169lbs \u2022 Heart: RRR, no murmurs \u2022 Lungs: CTA, chest wall symmetrical \u2022 Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia \u2022 Abd: soft, normoactive bowel sounds, neg rebound, neg murphy\u2019s, negMcBurney \u2022\u00a0<strong>Diagnostics:<\/strong>\u00a0HSV specimen obtained Assessment: \u2022 Chancre\u00a0<strong>PLAN<\/strong>: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.<\/p>\n<p>Assignment: Assessing the Genitalia and Rectum<\/p>\n<p>Patients are frequently uncomfortable discussing with healthcare professional\u2019s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.<\/p>\n<p>In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.<\/p>\n<p>To Prepare<\/p>\n<p>\u00b7 Review the Episodic note case study your instructor provides you for this week\u2019s Assignment. Please see the \u201cCourse Announcements\u201d section of the classroom for your Episodic note case study.<\/p>\n<p>\u00b7 Based on the Episodic note case study:<\/p>\n<p>o Review this week\u2019s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.<\/p>\n<p>o Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.<\/p>\n<p>o Consider what history would be necessary to collect from the patient in the case study.<\/p>\n<p>o Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient\u2019s condition. How would the results be used to make a diagnosis?<\/p>\n<p>o Identify\u00a0<strong>at least five<\/strong>\u00a0possible conditions that may be considered in a differential diagnosis for the patient.<\/p>\n<p>The Lab Assignment<\/p>\n<p>Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.<\/p>\n<p>\u00b7 Analyze the subjective portion of the note. List additional information that should be included in the documentation.<\/p>\n<p>\u00b7 Analyze the objective portion of the note. List additional information that should be included in the documentation.<\/p>\n<p>\u00b7 Is the assessment supported by the subjective and objective information? Why or why not?<\/p>\n<p>\u00b7 Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?<\/p>\n<p>\u00b7 Would you reject\/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.<\/p>\n<p><strong>Resources for reference ( need 3 + references)<\/strong><\/p>\n<p>Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &amp; Stewart, R. W. (2019).\u00a0<em>Seidel\u2019s guide to physical examination: An interprofessional approach<\/em>\u00a0(9th ed.). St. Louis, MO: Elsevier Mosby.<\/p>\n<p>\u00b7 Chapter 17, \u201cBreasts and Axillae\u201d<br \/>\nThis chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.<\/p>\n<p>\u00b7 Chapter 19, \u201cFemale Genitalia\u201d<br \/>\nIn this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia.<\/p>\n<p>\u00b7 Chapter 20, \u201cMale Genitalia\u201d<br \/>\nThe authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.<\/p>\n<p>\u00b7 Chapter 21, \u201cAnus, Rectum, and Prostate\u201d<br \/>\nThis chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.<\/p>\n<p>Dains, J. E., Baumann, L. C., &amp; Scheibel, P. (2019).\u00a0<em>Advanced health assessment and clinical diagnosis in primary care<\/em>\u00a0(6th ed.). St. Louis, MO: Elsevier Mosby.<\/p>\n<p>Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., &amp; Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.<\/p>\n<p><a title=\"Chapter 5, \u201cAmenorrhea\u201d\" href=\"https:\/\/class.content.laureate.net\/1a2455018bb6e05f03ebba70dfca8222.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 5, \u201cAmenorrhea\u201d<\/a><br \/>\n<a title=\"Chapter 5, \u201cAmenorrhea\u201d\" href=\"https:\/\/class.content.laureate.net\/1a2455018bb6e05f03ebba70dfca8222.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.<\/a><\/p>\n<p><a title=\"Chapter 6, \u201cBreast Lumps and Nipple Discharge\u201d\" href=\"https:\/\/class.content.laureate.net\/8349b14d970285a83a97532ab5cf7ce8.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 6, \u201cBreast Lumps and Nipple Discharge\u201d<\/a><br \/>\n<a title=\"Chapter 6, \u201cBreast Lumps and Nipple Discharge\u201d\" href=\"https:\/\/class.content.laureate.net\/8349b14d970285a83a97532ab5cf7ce8.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam.<\/a><\/p>\n<p><a title=\"Chapter 7, \u201cBreast Pain\u201d\" href=\"https:\/\/class.content.laureate.net\/8c913f6a06d80ac3bdfcbdde3361dafb.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 7, \u201cBreast Pain\u201d<\/a><br \/>\n<a title=\"Chapter 7, \u201cBreast Pain\u201d\" href=\"https:\/\/class.content.laureate.net\/8c913f6a06d80ac3bdfcbdde3361dafb.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient\u2019s health history.<\/a><\/p>\n<p><a title=\"Chapter 27, \u201cPenile Discharge\u201d\" href=\"https:\/\/class.content.laureate.net\/d5dcc2db965a84521d8f58e651f018e4.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 27, \u201cPenile Discharge\u201d<\/a><br \/>\n<a title=\"Chapter 27, \u201cPenile Discharge\u201d\" href=\"https:\/\/class.content.laureate.net\/d5dcc2db965a84521d8f58e651f018e4.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient\u2019s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.<\/a><\/p>\n<p><a title=\"Chapter 36, \u201cVaginal Bleeding\u201d\" href=\"https:\/\/class.content.laureate.net\/a4d1902572c7fc5c36f19e026fd3f5e4.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 36, \u201cVaginal Bleeding\u201d<\/a><br \/>\n<a title=\"Chapter 36, \u201cVaginal Bleeding\u201d\" href=\"https:\/\/class.content.laureate.net\/a4d1902572c7fc5c36f19e026fd3f5e4.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.<\/a><\/p>\n<p><a title=\"Chapter 37, \u201cVaginal Discharge and Itching\u201d\" href=\"https:\/\/class.content.laureate.net\/c6c32b4479cd039969661af75cdd1899.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Chapter 37, \u201cVaginal Discharge and Itching\u201d<\/a><br \/>\n<a title=\"Chapter 37, \u201cVaginal Discharge and Itching\u201d\" href=\"https:\/\/class.content.laureate.net\/c6c32b4479cd039969661af75cdd1899.pdf\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies.<\/a><\/p>\n<p>Sullivan, D. D. (2019).\u00a0<em>Guide to clinical documentation<\/em>\u00a0(3rd ed.). Philadelphia, PA: F. A. Davis.<\/p>\n<p>\u00b7 Chapter 3, \u201cSOAP Notes\u201d<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4356184\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., &amp; Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature.\u00a0<em>Polish Journal of Radiology, 80<\/em>, 122\u2013127. doi:10.12659\/PJR.892706. Retrieved from https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4356184\/ \u00a0<\/a><\/p>\n<p><a title=\"What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men\" href=\"https:\/\/www-sciencedirect-com.ezp.waldenulibrary.org\/science\/article\/pii\/S1590865814006690?via%3Dihub\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Sabbagh , C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., &amp; Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men.\u00a0<em>Digestive and Liver Disease, 46<\/em>(12), 1082\u20131085. doi:10.1016\/j.dld.2014.08.045<\/a><\/p>\n<p><a title=\"Do new guidelines and technology make the routine pelvic examination obsolete?\" href=\"https:\/\/ezp.waldenulibrary.org\/login?url=https:\/\/search.ebscohost.com\/login.aspx?direct=true&amp;db=rzh&amp;AN=104990855&amp;site=ehost-live&amp;scope=site\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Westhoff , C. L., Jones, H. E., &amp; Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete?\u00a0<em>Journal of Women\u2019s Health, 20<\/em>(1), 5\u201310.<\/a><\/p>\n<p>This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.<\/p>\n<p><a title=\"Sexually transmitted diseases (STDs).\" href=\"http:\/\/www.cdc.gov\/std\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Centers for Disease Control and Prevention. (2019).\u00a0<em>Sexually transmitted diseases (STDs).<\/em>\u00a0Retrieved from http:\/\/www.cdc.gov\/std\/#<\/a><\/p>\n<p><a title=\"Sexually transmitted diseases (STDs).\" href=\"http:\/\/www.cdc.gov\/std\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.<\/a><\/p>\n<p><center><a href=\"http:\/\/onlineclassesguru.com\/orders\/ordernow\"><img decoding=\"async\" src=\"https:\/\/encrypted-tbn0.gstatic.com\/images?q=tbn:ANd9GcTyj99p60XCLyLk1htB7-1neRt8-2QdnenNlQ&usqp=CAU\"target=\"_http:\/\/onlineclassesguru.com\/orders\/ordernow\"\/><\/center><p>","protected":false},"excerpt":{"rendered":"<p>Episodic note Case Study\u00a0: \u00a0Special Examinations\u2014Breast, Genital, Prostate, and Rectal GENITALIA ASSESSMENT Subjective: \u2022 CC: \u201cI have bumps on my bottom that I want to have checked out.\u201d \u2022\u00a0HPI\u00a0AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She state: s the bumps are painless and feel rough&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-13031","post","type-post","status-publish","format-standard","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Examination of breast, genital,postate and rectal - onlineclassesguru<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/onlineclassesguru.com\/index.php\/2020\/11\/24\/examination-of-breast-genitalpostate-and-rectal\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Examination of breast, genital,postate and rectal - onlineclassesguru\" \/>\n<meta property=\"og:description\" content=\"Episodic note Case Study\u00a0: \u00a0Special Examinations\u2014Breast, Genital, Prostate, and Rectal GENITALIA ASSESSMENT Subjective: \u2022 CC: \u201cI have bumps on my bottom that I want to have checked out.\u201d \u2022\u00a0HPI\u00a0AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. 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